Prognosis of Psoriatic arthritis
How does the prognosis of PsA compare with that of rheumatoid arthritis?
PsA and rheumatoid arthritis have a similar prognosis and effect on quality of life. Historically, 60% of patients have erosive arthritis in five or more joints and 40% have joint deformities and/or spine involvement. Up to 20% will develop ACR class III or IV functional impairment with disability. A younger age of onset, female sex, acute onset of arthritis, polyarticular disease, and elevated ESR/CRP all predict a poor prognosis. In addition, mortality is increased, with a standardized mortality ratio of 1.36. Studies have established a link among psoriasis, obesity, the metabolic syndrome, hyperuricemia, and premature atherosclerosis.